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Vol. 53. Núm. 5.
Páginas 470-478 (noviembre 2000)
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Vol. 53. Núm. 5.
Páginas 470-478 (noviembre 2000)
Acceso a texto completo
Estudio prospectivo sobre el empleo de catéteres umbilicales en el recién nacido
Prospective evaluation of umbilical catheters in newborn infants. the castrillo hospital group
Visitas
8892
B. Fernández Colomer, A. Ramos Aparicio, J.B. López Sastre, G.D. Coto Cotallo, Grupo de Hospitales Castrillo *
Hospital Central de Asturias. Oviedo
Este artículo ha recibido
Información del artículo
Objetivo

Conocer la situación actual en nuestro país sobre el empleo de catéteres umbilicales en recién nacidos, analizando características técnicas y complicaciones infecciosas, mecánicas y locales.

Métodos

Entre el 15 de julio de 1997 y el 31 de diciembre de 1998, en los servicios de neonatología de los hospitales integrantes del Grupo de Hospitales Castrillo se estudiaron prospectivamente los catéteres umbilicales colocados en recién nacidos.

Resultados

Se han estudiado 489 catéteres umbilicales (201 venosos y 288 arteriales) colocados en 475 recién nacidos. Se insertaron con facilidad, permanecieron colocados por lo general menos de 5 días y la mayoría se retiraron de forma electiva. Se enviaron para estudio bacteriológico 461puntas de catéter (94,3 %) y en 98 (21,2 %) el cultivo resultó positivo; 85 (18,4 %) se consideraron contaminados y 11 (2,4 %) con sepsis relacionada con catéter (SRC). Staphylococcus epidermidis fue el germen aislado más habitualmente (72,2 % en contaminación y 63,6 % en SRC). La permanencia del catéter 3 días o más fue el principal factor de riesgo para la contaminación y para la SRC fueron la permanencia 3 días o más y el peso del recién nacido menor o igual a 1.500 g. El 7,9 % de los catéteres venosos y el 9% de los arteriales presentaron complicaciones locales; la salida accidental fue la complicación más habitual en los catéteres venosos (3,98 %) y alteración de perfusión en extremidades en los arteriales (2,77 %).

Conclusión

Los catéteres umbilicales en nuestra casuística, han tenido una baja incidencia de complicaciones. Debe evitarse una permanencia prolongada y así los beneficios prevalecerán sobre los riesgos en estos catéteres.

Palabras clave:
Catéter umbilical
Neonato
Factores de riesgo
Sepsis relacionada con catéter
Staphylococcus epidermidis
Estudios prospectivos
Análisis multivariante
Objective

To evaluate the current use of umbilical catheters in newborn infants in Spain by analyzing technical characteristics and infections, as well as mechanical and local complications.

Methods

Umbilical catheters inserted in newborns in the neonatal units of the hospitals in the Castrillo Hospital Group from July 15, 1998 to December 31, 1998 were collected for prospective analysis.

Results

A total of 489 umbilical catheters (201 venous and 288 arterial) placed in 475 newborns were analysed. No difficulties were found in inserting the catheters and they had an average indwelling time of less than 5 days. Most were removed electively. A total of 461 (94.3 %) catheter tips were sent for microbiological examination and cultures were positive in 98 (21.2 %). Of these, catheter contamination was found in 85 (18.4%) and catheter-related sepsis was confirmed in 11 (2.4 %). Staphylococcus epidermidis was the most commonly isolated organism (72.2% of contaminated catheters and 63.6% of catheterrelated sepsis). The main risk factor for contamination was duration of catheterization $ 3 days and that for cather- related sepsis was duration of catheterization $ 3 days and birth weight # 1500 g. Local or mechanical complications were documented in 7.9 % of venous catheters and 9% of arterial catheters. The most common complications were accidental dislodgment in venous catheters (3.98%) and clinical vascular compromise in the lower extremities in arterial catheters (2.77 %).

Conclusions

In our experience, the umbilical catheter had a low complication rate. To ensure that the benefits of catheterization outweigh the risks, prolonged use of these devices should be avoided.

Key words:
Catheterization
Umbilical arteries
Umbilical veins
Newborn infants
Risk factors
Sepsis
Staphylococcus epidermidis
Prospective studies
Multivariate analysis
Catheters
Indwelling
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Copyright © 2000. Asociación Española de Pediatría
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